We’re In The Middle of a Pandemic!!!

We’re In The Middle of a Pandemic!!!

WE’RE IN THE MIDDLE OF A PANDEMIC!!

By Doris M. Waite, RDH, COMT

 
Not the Covid-19 virus and all its variants but something we’ve been unknowingly doing to our children. First, there are over 1 BILLION people in the world with Obstructive Sleep Apnea (OSA). How did that happen?  Well, it’s a sad story..... but let’s start at the beginning.

At the beginning of the Industrial Revolution, many people moved to cities to be closer to jobs.  They weren’t growing their own food anymore and eating it but began to eat foods that were packaged and eventually processed for “easy” consumption.  This change occurred over 150 to 200 years and in that time, we developed some really bad habits!
By the middle of the Twentieth Century, there was so much packaging and processing going on that it was chic to buy your food in the grocery store rather than making it at home (typical for mid 50’s: aww, can’t we have store bought cookies??).

People looking to make money during the baby boom, developed formula and Pablum for easy consumption and advertised it as being “the best” for baby.  They even gave doctors and hospitals free samples of formula for distribution to new mothers “just in case”.  Just in case.....mom couldn’t breastfeed.  So if moms had trouble breastfeeding, they could just switch to a bottle - no problem.

But there was a problem that most people don’t know about.  Babies who are bottle fed often become mouth breathers because their tongue is being pushed down to eat and feels “comfortable” on the floor of the mouth.  Mouth breathing leads to nasal congestion which leads to more mouth breathing and the cycle continues.  In addition, mushed up baby food was (and still is!) being marketed as “best for baby”, even selling “Junior” foods that were not quite as liquefied.  Babies were not developing chewing muscles and their tongues were not being challenged to function AT ALL!

So what does this have to do with OSA?  It just so happens that development of the muscles in the mouth, cheeks, lips and throat are strengthened by breastfeeding and chewing on solid, challenging foods.  When the tongue and the muscles at the back of the throat are toned, the tongue stays in the mouth where it belongs and doesn’t fall into the back of the throat to block the airway.  A blocked airway is what causes OSA.

On a trip to Tanzania a few years ago, I noticed that EVERYONE had beautiful, wide arches and straight teeth.  The reason: moms breast fed their babies and weaned to table foods - no bottles, no formula, no baby food.  (there isn’t one orthodontist there either!)

The question now is: how do we prevent our children and grandchildren from suffering from OSA?  Well, you could move to Africa or breastfeed and wean to open cup, have children choose their own food (Baby Led Weaning) and full time nose breathing.

Babies who are unable to nose breathe need to have their noses rinsed out daily until they CAN nose breathe.  If it is a physical obstruction, fix it and get that little one nose breathing.  Snoring babies are NOT cute.  By age 5, 70% of a child’s face has grown so early intervention is imperative.

If you know of a little one who could benefit from early intervention, find an Orthotropic dentist who can assist with facial growth and development early.  The child will not “grow out of it” but will become a problem adult.

Doris Waite is a Registered Dental Hygienist, Certified Orofacial Myofunctional Therapist and Buteyko Breathing Educator.

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What Gets You Thinking

What Gets You Thinking

What gets you thinking?

When research in one area changes your treatment in another.

By Dale Gregore

 

Jung J-Y, Kang C-K. Investigation on the Effect of Oral Breathing on Cognitive Activity Using Functional Brain Imaging. Healthcare. 2021; 9(6):645. https://doi.org/10.3390/healthcare9060645

Reading the journal article referenced in this text made me think just as all research articles intend.  But here, the link with breathing and brain function/ cognition flashed in neon lights, reminding me again of the brain-breath connection.

We have all had the experience of reading an article and not resonating with the message or results at that moment.  However, at a different time or instance, re-reading that same article and really understanding the research principles, outcome and applications.  Whether it was timing or situational, this article popped out in my mind and made me think more about the need to be aware and even address breathing when working on memory with a patient.

Often in Speech Pathology, breathing is addressed when working on voice, swallow, and functional respiration during Activities of Daily Living (ADL.) Therapist may also work with patients on attention, information processing, comprehension, integration and higher-level cognitive functions such as working memory.  Those activities or therapy tasks are generally separate from voice, swallow, breathing.  After reading this article, I questioned…. should we incorporate breathing more into cognitive work?  Should we first address oral versus nasal breathing at rest and during a cognitive task?  Should we introduce nose clearing techniques and establish nasal breathing before starting on the memory task?  Hmmmmm, interesting!  This made me think and even discuss this and other research with my team of speech language therapists.  Things to be mindful of and to address; to note patient performance with oral versus nasal breathing……..was there a difference in pt progress or goal attainment?  Can nasal breathing be used as a memory task as well?  If we can habituate nasal breathing, we could facilitate significant changes physiologically and promote brain function that has increased learning potential.

The article Investigation on the Effect of Oral Breathing on Cognitive Activity Using Functional Brain Imaging, “investigated the effect of oral breathing on functional brain activity. It was confirmed that the functional connection decreased significantly during a working memory task in oral breathing rather than nasal breathing. Furthermore, the functional connections of the left cerebellum, and left and right inferior parietal gyrus appeared only during nasal breathing, but not during oral breathing. According to these results, oral breathing can interfere with the efficient performance of working memory. Therefore, brain areas closely related to working memory function were less active during oral breathing, suggesting that prolonged oral breathing could significantly induce impaired cognitive function together with various well-known side effects on the body. These findings also suggest that any solutions for oral breathing should be considered not only for dental care but also for working memory activity.”

What research gets YOU thinking? How has research in one area impacted your treatment in another? Things to think about…..

Dale Gregore
Level 1 Buteyko Educator, medical speech language pathologist with >35 years’ experience; board certification in swallowing; department/ program manager and adjunct professor.

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Climate Action – 10 things to make your home air safe

Climate Action – 10 things to make your home air safe

Climate Action – 10 things to make your home air safe

By Robert Litman

The editorials in the media call for much needed climate action. On a more immediate personal level it is time to prepare the air in our homes to best support staying healthy and sustaining health during difficult weather, pollution, viruses, bacteria, and fire conditions. Having clean air to breathe is now a serious issue.  The atmosphere in our homes can be managed for optimal breathing health. Without taking preventive steps the inside air can be as filled with smoke and pollution as the outside air even if you have your windows closed. Smoke seeps through crack and older poorly sealed windows. Being prepared now for possible futures of wildfires and deterioration of atmospheric conditions due to fossil fuel emissions will prevent the scramble for these items and finding them sold out. Some of these items are unfortunately already in short supply.

The more immediate way to refer to climate change is to realize that we are dealing with changes to our atmosphere, Atmospheric Change.  The air we share with the entire population of the planet is in danger. 91% of the world’s population does not have a steady daily supply of clean air. Close to 9 million a year die from air pollution. Respiratory illness and heart attacks and strokes prevail as the major cause of death.  Breathing polluted air steadily for several days will cause damaging inflammation. This is especially true for those who already have compromised immune systems, the elderly, pets, and children.  Air quality on Vashon can be poor for a few hours in the morning as the trucks arrive bringing food and other supplies. With air quality in the United States deteriorating for the first time since the Clean Air Act in 1967 we must be prepared now. Below I have listed some things to do. Some research is needed to get the equipment best suited to your needs and financial abilities.

Each home needs to have on hand:

  1. A good Air Quality Monitor to measure the inside air (inside air can be 2 to 3 times more polluted than the outside air) and know what kind of air you are breathing. This will guide you in implementing steps to improve the air quality if needed. Also to keep track of the results of the other air quality improvements being made. The monitor needs to have a reading for Carbon Dioxide levels. When there is smoke outside and we close all the windows, CO2 levels can rise quickly making one groggy and create a loss of cognitive abilities. Standards for co2 are online.
  2. An effective air purification setup to clean indoor air. To be effective the size of the air purifier must match the size of the room you are attempting to keep clean. Each purifier states the size of the room it will clean on the box. This is the CADR – Clean Air Delivery Rate. How many times will the air in the space be turned over per hour for the size of the room it is rated for. Decibel levels are also on the box so you will know if it will be too noisy for your comfort level. For HVAC systems an MERV 13 filter is necessary. Be sure your unit can handle that much filtration and not harm the motor.
  3. For smoke, the air purifier must have an activated charcoal filter along with a HEPA or True HEPA filter. Most also have a prewash filter to save filter life
  4. Air purifiers vary in price from under $100 up to $1000. Good reviews are available online
  5. Making your own air purifier for under $40 can be accomplished with a box fan and a MERV 13 furnace filter. Adding an extra activated charcoal filter can be a good idea. There are many videos on YouTube on how to make these.
  6. For smoke, masks need to have activated charcoal in them. Plain cotton masks do not filter smoke. Charcoal mask inserts are available for this purpose.
  7. It is advised by the Environmental Protection Agency to set up a clean room in your home. This would be a room that has clean purified air with no openings that allow smoke from the outside to enter. Again, instructions are on the EPA website and YouTube on how to accomplish this. It must have fresh circulating air, one that provides heating and cooling.
  8. A pulse oximeter to monitor saturation levels of oxygen in the blood when you are feeling breathless. These readings will tell you when it is urgent to get help.
  9. What not to do when there is smoke in the air. No cooking in the house or outside. No vacuuming which creates dust in the air. When the smoke is bad, take a shower and wash pets when you come back inside, otherwise you carry the debris into the house. Keep children off the floor and away from smoke debris carried into the house. Nasal washes are a good idea too after being outside.
  10. Nasal breathing only is a must if possible. Mouth breathing takes all the smoke and pollution directly into your lungs. Nasal breathing gives the nose a chance to filter and condition the air for the lungs.

Robert Litman – The Breathable Body Vashon – robert@thebreathablebody.com -206-707-1639 www.thebreathablebody.com

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Post Hip Surgery Relief

Post Hip Surgery Relief

Post Hip Surgery Relief

Steve McGillen, Level 2 educator, Buteyko Educator since 2013.

My hip surgery(total replacement) booked for April 2020 took a cancellation due to Covid until October 7, 2020.  I'd kept myself busy but with 100 metre walking tolerances, I was sedentary, retired and used control pauses for pain.

The rosy picture painted by the surgeon and the physiotherapist was excellent marketing and the epidural does last into the second day for full pain relief. However, don't kid yourself, Day 2-4, I felt like I had been hit by a truck. I could not lift my leg and needed assistance to even move my legs in and out of bed and to navigate a two wheel walker? at a tortoise pace. I was bruised and black and blue from hip to the knee. Yes, I looked forward to my 5 ice packs a day and naps. But by day 4, I needed a schedule. I craved some order from this open...do what you feel or do what physically you can do...and get up every 2 hours and do your exercises..

The physio mantra...do your exercises...15 min..@3 times a day.......ok? ok.  It was easy on the morphine.   

So, I grabbed my Buteyko Workbook and did a foundation set after every ice pack session.  The benefit was there. The comfort in the calm.  The quiet in my breathing. I gained a stronger ability to focus and some control. The morphine for me addressed the pain but the brain fog, wow...Doing a set provided clear simple work. The joy of being on task was refreshing as each day was unpredictable. It was a guess as to which leg part would work or hurt and to MacGyver a solution with the home options of: heat, cold, massage, naps, medication, water, food and yes, breathing .  

In closing, it's been three weeks with improvement and I've now graduated to a 4 wheel walker. My daily 5 foundation sets are my comfort, my efficacy and my friend.  As for Covid, I'm into 4 weeks isolation as a patient with no visitors. I honestly have not watched TV.   I technically know the body’s immune system but in reality, it's a wonder how it works.  I still use my back-up systems: hoping, praying, dreaming and laughter.  Well, it's been a necessary but frightening, humbling experience. My titanium hip is in, structurally sound to date and I can set some new goals.  I am grateful.

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Lifestyle Medicine

Lifestyle Medicine

Lifestyle Medicine 

By Arend Hoiting - L5 Buteyko Educator and Trainer  

It is well known that medical intervention in the Western world consists mainly of medications, which are often prescribed in unbridled quantity. Increasingly, the numerous side effects of medication are perceived as infuriating and dangerous, and people in turn start looking for alternatives, for example in complementary medicine such as the Buteyko method. The many doctors I have had as clients have told me that they were never taught about breathing as a medical notion during their medical training. This is further supported by medical students when you ask them what they are studying. The answer is almost always: “I study medicine”. The emphasis is thus on “curing” by use of medication.

It is remarkable, and I think even unique that a large number of medical specialists from university medical centres in the Netherlands have partnered with the very well-known Dutch TNO organisation in The Hague. The TNO is the Netherlands Organisation for Applied Scientific Research. The TNO connects people and knowledge to create innovations that strengthen the competitiveness of companies and the well-being of people in a sustainable way. The TNO focuses on nine main areas, among others, Construction, Infrastructure and Maritime, Environment, Energy, Information and Communication Technology, Healthy Living, Industry, Strategic Analysis and Policy.  

A large group of medical specialists have united themselves in the organisation “Lifestyle4Health” and they describe the lifestyle as: “The whole package of nutrition, exercise, relaxation, sleep, reduction of exposure to toxic substances, and psychosocial support is of great importance to be and stay healthy. The fact that lifestyle interventions can be used for the recovery or treatment of disorders is less well known, even though several studies have been suggesting this for some time.” In summary, medical specialists in the Netherlands see lifestyle medicine as the research into the application of lifestyle interventions in curative healthcare as part of the medical treatment of diseases. 

Personally, I believe the core idea of scientists should be curiosity and I therefore got in touch with the initiator of the Lifestyle4Health organisation Prof. Dr. Hanno Pijl, endocrinologist at the Leiden Medical Centre (lumc). I pointed out to him the application of the Buteyko method in healthcare and indicated to him that Buteyko Specialists are also advocates of an integrated approach, such as Misha Sakharoff has been doing for years in his work with people with cancer. I am also personally in favour of supporting clients with regards to the psychological components of trust and anxiety which relate to each other as two communicative vessels. A stress reduction system such as mindfulness (Misha calls this 1-p attention) should also be addressed. It is not only about normal breathing when in a rest state, or only about exercise, nor is it only about having a better diet, or just reducing stress. The guidance should be an integrated approach which deals with all facets. This is also the promising approach of the Lifestyle4Health organization. I would almost call it a revolutionary approach, a turning point in thinking among medical specialists.  

Disappointing is the lack within this group when it comes to normal breathing in rest, a consistent breathing through the nose while at rest, on the move, and while speaking. Hanno Pijl’s response was disappointing and short: “I am only interested in scientific evidence for the Buteyko method”. He was also not sensitive to the argument that breathing is at the beginning of all life processes: the metabolism, the immune system, the endocrine system, and the central nervous system. Sadly, we often see that medical specialists are normative. They fully adhere to the standard of scientific research as something which is either true or false, for example by starting scientific research using an experimental and control group. I confronted him with the many clients that have been cured of heart diseases, COPD, and other disorders, and I still have the habit of calling clients after several years to find out whether they are still free of complaints and medication. I often hear from medical specialists that people like to refer this to the category of “spontaneous cures”.

Nevertheless, I am convinced that we should welcome this medical initiative in the Netherlands.

Arend Hoiting
Buteyko Specialist
Buteyko Noord Nederland
Ter Borch 16
9492 RB Zuidlaren
T : 050-4093448
M: 06-52450946
www.buteykonoordnederland.nl
a.e.hoiting@xs4all.nl

Lid Vereniging van Buteyko Therapeuten (V.B.T.)
Member of the Buteyko Breathing Educators Association (MBBEA) L5 Buteyko Educator and Trainer
Member (fellow) of the Buteyko Professionals International  (BPI)

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Buteyko Breathing, Abdominal or Diaphragmatic?

Buteyko Breathing, Abdominal or Diaphragmatic?

Buteyko Breathing, Abdominal or Diaphragmatic?

Written by: Janet Winter, U.K. - Level 3 Buteyko Educator

First Published in an earlier version of Breath Notes

I recently noted that some Buteyko practitioners talk about abdominal (belly) breathing and some talk about diaphragmatic breathing. So I was asked to explain the difference! I am sure that we are all in agreement that the predominantly chest breathing pattern with which many of our clients start off needs to be discouraged, and relaxed breathing—low and slow—promoted.

But when it comes to belly or diaphragm, belly breathing could be rather unrelaxed, holding the rib cage stiff and pumping in and out of the abdomen. I am a relative newcomer as I have only been a Buteyko practitioner for a couple of years, and some of you are breathing experts, but I thought I would just share 2 descriptions of good breathing that I have found very useful.

The first is from a British choir master, as seen on TV http://www.garethmalone.com/sing/tips (click on the “breathing” tab) and is very short and sweet. For getting air into the bottom of the lungs for good singing his tip is: “Imagine you have a rubber ring around your waist (your diaphragm). The trick is to try and push the imaginary rubber ring outwards with your body.”

This seemed to explain what we want simply and clearly, I always tell this now to my clients. The rib cage has to expand and the diaphragm must contract if you follow these instructions.

The second is from an excellent site from an Alexander Technique teacher, (Philip Pawley, died January 2012) also in the UK. I know that some AT teachers call abdominal breathing “abominable breathing!” This one goes into lots of interesting detail. I often recommend to my clients that they look into AT to learn more about breathing, after they have learned initial control, and increased their control pause with Buteyko.

There are three main kinds of breathing:

  •  Chest Breathing
  •  Belly Breathing (unsupported diaphragm)
  •  Diaphragmatic Breathing (properly supported)

Chest Breathing

Breathing with the upper chest is the most effortful and least productive of the three. The chest and neck muscles lift the breast-bone and upper ribs. As the breast-bone comes up, it also comes forward.

This inflates the upper lobes of the lungs. Because they are small, only a small volume of air is drawn in. This means rapid, short breaths. The effort involved is considerable. It is also a drag on the head, neck and shoulders so that these have to be braced in order to provide an Archimedean point from which the upper chest can be lifted.

This type of breathing is characteristic of anyone who is struggling for breath.

The Diaphragm

When the dome-shaped diaphragm muscle tightens to draw air into the lungs, it flattens. This can happen in one of two ways:

  1. the top of the dome comes down but its edges are fixed, (un-supported diaphragmatic breathing)
  2. the dome also lifts the ribs as its edges come up. (supported diaphragmatic breathing)

Belly Breathing (unsupported diaphragm)

This is usual but not very effective. The lower ribs don’t move much. This is for two reasons. Firstly, because the diaphragm isn’t lifting them. Secondly, because over-tight muscles are stopping the ribs from moving. Instead, the top of the dome, moving down, creates space for the lungs to expand into.

This method of breathing also pushes down on the abdominal organs. They have to go somewhere. As a result, they end up bellying out in front — a characteristic of unsupported diaphragmatic breathing. The fact that many people breathe in this way is the main reason why a ‘beer-belly’, or ‘middle-aged spread’, is so frequent even in people who are not over-weight, don’t drink beer and are not yet middle-aged!

This piston-like action is often believed to be the proper action of the diaphragm. In fact, it’s only one part of the story. The best use of the diaphragm is only possible when it is getting its proper support, as we shall now see.

Diaphragmatic Breathing (properly supported)

The dome-shaped diaphragm muscle is attached by its edges to the lowest ribs, the costal arch, the base of the breast-bone and (at the back) to the front of the lumbar spine.

Superior view of cross-section of diaphragm, the main muscle of breathingIn supported diaphragmatic breathing, because the abdominal organs are supported in place, the top of the diaphragm cannot come down as much as it does in unsupported diaphragmatic breathing. (We will look later at what provides this support).

This support provides the “Archimedean point” enabling the diaphragm to lift the lower ribs. (These lower ribs are the ones which join together in front to form the costal arch instead of attaching directly to the breast-bone).

The way these ribs are jointed to the spine means that, as they come up, they must also come out sideways (not forwards as the upper ribs do). To picture the movement of one of these ribs, imagine starting to lift the handle of a bucket from its rest position, where it lies against the side of the bucket; imagine lifting it up-and-out sideways. The movement of the rib is just like this. The result of all the lower ribs moving together in this way is a big sideways expansion: an expansion of one’s back just as much as it is an expansion of one’s lower chest. This inflates the large lower lobes of the lungs very considerably.

Since a very large volume of air flows in and out of the lungs, one naturally breathes much more slowly this way. This all makes for effortless breathing. Another advantage is that, while upper chest breathing creates a downward drag on the head and neck, this support for the diaphragm actually acts as a hydraulic lift, buoying one up and greatly reducing the effort of maintaining an erect posture.

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Buteyko Trials in Egypt and the Philippines

Buteyko Trials in Egypt and the Philippines

Egyptian Trial Shows the The Buteyko Breathing Technique Improves Lung Function

By: Charles Florendo, MD, Cameroon

A recent trial conducted in Egypt and published at the Egyptian Journal of Chest Diseases and Tuberculosis shows that theButeyko Breathing Technique not only improves asthma control but can improve Peak Expiratory Flow Rates (PEFR) as well.

This is a welcome development as it is the first published study to record improvements in lung function among asthmatics subjects taking up the Buteyko Breathing Technique. The study had 40 participants, 20 of whom were taught the Buteyko Breathing Technique while another 20 only received medical management. The study followed up participants for 6 weeks which showed that PEFR improved by 51% in the Buteyko group as compared to only 3.6% in the control group. The Buteyko group also showed decreased daily symptoms by 52% as compared to only 0.8% in the control group.

Some other interesting notes done by the trial were that the researchers measured and recorded the participants control pauses (CP) as well. Participants in the Buteyko group had increased their CP by 69% compared to only 8% in the control group. Much like in previous studies, the Buteyko group also decreased their use of inhaled steroids by 33% compared to 15% in the control group.

The study did not mention who was the Buteyko Practitioner involved in the study. This is perhaps the first African study of the Buteyko breathing technique to be published. With it though comes the distinction that clinical studies on the Buteyko breathing technique have been completed and published from all five inhabited continents of the planet: America, Europe, Australia, Asia, and now Africa.

To search for the trial online, you may look for: Hassan, Riad, Ahmed. Effects of Buteyko Breathing Technique on patients with Bronchial asthma. Click HERE for link to Egyptian Journal of Chest Diseases and Tuberculosis (2012) 61, 235-241.

Nursing students in the Philippines prove that Buteyko is safe and effective for Kids

A group of nursing students from the University of Santo Tomas in the Philippines conducted a trial on the Buteyko Method involving children 7-11 years of age as part of their thesis. With assistance from Buteyko Practitioners Dr. Charles Edward Florendo, and Patrick McKeown, the students followed up 7 children who took up Buteyko, and 7 others who did not. All the children were diagnosed with asthma by a pediatrician. The children were assessed using the Filipino versions of the Pediatric Asthma Quality of Life Questionnaire, and the Asthma Control Questionnaire. They were followed up for 4 weeks. Children who took up Buteyko were taught the Buteyko Steps exercises as well as games promoting proper breathing. The Buteyko group noted significant improvements in both the quality of life and asthma control scores on the third and fourth weeks after their initial tuition. On the other hand, no significant difference were noted for children in the control group. The group who made the thesis received a good grade and were invited to present their paper in conferences in Singapore and Canada.

The nursing students are Romella C. Lina, Matthew Daniel V. Leysa, Zarah DF Libozada, Maria Francesca I. Liro, Angelo Liwag, Gabriel D. Ramos, and their thesis adviser is Margaret M. Natividad RN, M.Ed. Click HERE for a downloadable version of this thesis.

 

 

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